In a speech at JPMorgan’s 36th annual health care conference earlier this month, Bill Gates argued that investments in high-tech biomedical treatments for diseases like cancer could also help develop better ways to control the kinds of infectious diseases that afflict underdeveloped countries.
One of the high-tech therapies described by Gates was cancer immunotherapy, which involves using chemicals or even genetic modifications to stimulate the body’s immune system to attack tumors. While often very effective at treating cancers that have been resistant to chemotherapy or surgery, immunotherapies are also among the most expensive medicines in the world with some costing more than $150 per milligram—making them worth about 3,000 to 4,000 times their weight in gold. While immunotherapies are now being used for the most difficult to treat cancers, in principle these therapies could be used to help the body’s immune system respond to infectious disease—our bodies’ immune systems are designed, after all, to fight not only cancers but foreign pathogens as well.
Other approaches emphasized by Gates included new genetic vaccines that use mRNA molecules to help the body’s immune system to develop new cancer vaccines—but such technologies could also help doctors quickly develop safe and effective vaccines in response to pandemics.
The Bill and Melinda Gates Foundation is better known for its “effective altruism” approach that emphasizes cost-effective ways to save as many lives as possible—generally in poor and developing countries—than it is for supporting high-tech biomedical innovations. Indeed, Gates notes in the speech that Alzheimer’s research is outside the foundation’s purview. And it is true that high-tech, futuristic therapies are often not what are most urgently needed for the millions of people living in dire poverty and suffering from the infectious diseases. Building the infrastructure to provide sanitary conditions and safe drinking water, providing adequate nutrition—especially for children—and extending the coverage of existing vaccines are all extremely important ways to improve the health, and the Gates Foundation has done admirable work addressing these problems.
But the importance of these kinds of effective altruism strategies don’t mean that the very difficult work of finding treatments for diseases like cancer and Alzheimer’s are unimportant. Though some effective altruists argue that we put too much emphasis on cancer research, the idea that there is a zero-sum game between high-tech medicine and more cost-effective global health is misguided. If we reduced investments or charitable contributions in cancer research we would be left with thousands of smart, motivated scientists who would be more likely to find work in some other lucrative biomedical field rather than rededicating their lives to the very different work of helping underdeveloped countries solve public health problems. The approach articulated by Gates in this recent speech is more promising: find ways to use cutting edge biomedical technology to save lives around the world.
Brendan P. Foht is associate editor at The New Atlantis.
